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COMMENTS
<br />4r
<br />Buildin Sewer
<br />lnterce tori Clarifier
<br />UNDER GROUND
<br />Waste & Vent
<br />Water-Under Iloor
<br />Area/Storm Drain
<br />0'-(t,rffWater Pi tn
<br />Gas Pi rn
<br />TOP OUT
<br />Roof Drain
<br />Waste & Vent
<br />Tub/Shower Test
<br />Rough Water Heater
<br />POOL/SPA
<br />P-trap/Drain Line
<br />Main Drain/Pool Pipinq
<br />Fill Line/Back Flow
<br />Pool Heater/Gas Line
<br />Miscellaneous
<br />Gas Service
<br />Lawn Sprinkler
<br />Sanitary SeweriCap
<br />Back Flow Device
<br />U-trRouh Plumbin
<br />Notes, Remarks, Etc.
<br />FINAL
<br />Meter Release
<br />Final Gas Test
<br />4,1t./,; , nth,,t.,n,.,]- r.,*t-,1"-,/,ea)l',., Jro*t a.*/U,rahA
<br />' ii )- o, i* i, .{c-t, 2 ln,, t tol^,! ril alu - -/,,--,.- d*4\Hrtz-
<br />,lr r,/t t,rn;firklT /h#;f*;Z,, f-7-oI2
<br />OWNER BUILDER DELCATATION
<br />I hmhy iffm unds pendry or F.iury thd I @ cx.trrpr fmm thc Contrelos Litn* ljw for lh. followir8 r.&$n (S.t.70.1!.5
<br />Blsiicss snd Prcfcsion Codc): Any Cny or Coln|y which Equies r lEmir lo 6.srrucr. rlr{. imprev., rhmlbh rlJ Epair any
<br />$ru.t@, Itribr ro irs hsurrce. al$ Equies fic amlher lor such Fmi ro fih a s'ei.d !t!te@l lhal tp or snc ir lic.nsd plMa ' .
<br />ro rhc prcvisio.s oa tlE C,nrmrols LiccnFd L!* (Chlprc 9. Conftming enh S{Ihn 7l0O of Divilion 3 of lh. Blsin.ss and
<br />Pbacsiofls Codc) or ltar lr tr dE ir ei.nlol rh.Efrom rId thc b.ris for rlt .lkgcd .xcauion. Aryviob6nofS.dhn?03,.5byany
<br />apd'crfl for ! ,cmn ilbjNr. tlf, lpplic. ro ! .ivil ocNly of rcr mc tun iivc hundFd dollin (t5m).
<br />.--1.$own.rolr[cpr)pcny.nrnrlcDrnk)yccssilh$trrc\n\rlEirsolc.onr i\!itr)n. $'lldo dt tru* drh.{nrhnisml
<br />rh.I()jrdy rr()hrld(orirnD.vc\rlN(rn.!,nlqhod'E{{r.htrukhmsclirrhcr{llorlh'ouAhhi\ rncr.si. [nyccr,
<br />tmlid.dihsrruchi'nnntrcnr srrnrri'cidcdorollceallnr!'L1r,lrN.\cr.ih(huiurrSo!nv(r,xlEnri\$lllsirhnronc\rr
<br />olc.nlPtrion, rh. Osncr Auiur $ill lNr rh. hrrdcn ofpn,r'ng rhrt h..r nr id nor htrild o.irnpn,\. rht Imtdytu' rlf,lfurrx,{ol
<br />-1,
<br />as ow*r oi rnc pmlJ.rry. m cr.hsivcly conrracrin8 with liccnscd contscroii ro onnrud *E Dmi*l (S(. 7044. Busms
<br />ad EoftrsihCodciThc Cofiacroas Li.cns. Law docs.or applyro a6own.r ofpmp.rly eho huilds or imrowi lhden.
<br />md who .onimk lor Mh l,mtrrs *nh ! Conkro(t liccn$d puGunr ro rllc Contradols Liensc t s).
<br />lme!.m undcserb. . B. & P.C.forrhnEsn.
<br />IVORKEIS' COMPENSAI'TON
<br />DECI/AAIIO!
<br />I hcrcb, a,firm und6 Fnahy of pdjury oE of lhc lolLwing dmldaionq
<br />-l
<br />h.v. and *ill @iniain o Cenifrltc of Comnr ro Scla lnsnrc for *or*cm oqf,netir,n, eq thvid.d lor by sdrion 3700 oa llE
<br />Libdr Code. for rhc rEfolr1@e ol h. h.t fo, ahich UE p6nir & hsBd.
<br />,l hlvc snd will minroin workcft comFnsrrion insurlre. !s rcquircd by Stl ion l'700 ol rhc libor C.d., lor thc p.rfommc of
<br />llE work for which lhis p.mi is L$kn. My *ork6 coq,cnstioi in$rftc cekr ald !6li.y nunl*. m:
<br />_l ccrtiry rhar in rhc pcrrormnrr oirhc work ftr which lhk pernrn is issucd. I sholl not cryrloy any pcron in any mnner
<br />v, os to ttsm subirr !o rhc wo*.R mmFcnsorion hqs ol C.lifomi.. and osEc rh,t ir I shuld bc.om subF.l lo llf,
<br />mrtcs omp.nslioo pmvisions ol Sdior lT00 of lhc LalEr tuc. l shlll. fonhwnh.dn{,ly wnh lh,e pmishns.
<br />WARNIN(;: ,:rilurc b s.-^ue workcn cotr,p.trur l. {nd shall subJc.l 0n cmnlo}cr lo siniial FeX.3 ojd
<br />rhc cosr ofcomrcnstioi. damgcs ns lmtidcd fo, thccivil linc\ !t ro .nc hrndrcd rhous'nd dorlrs
<br />.r8 -""' g^^ L-' ,-t4 l
<br />I hcruby amrn undcr p.ndry ol rerjury ,D liansn und.r tovisnrn ol Ch0ptcr 9 (ommncirs wirh Sdion 7m0r ofDivision l
<br />ol rhc llu\inc$ lnd PRntsbns Codc. dil rylic.n\. i\ i.ltlltu.c rndcl,icr.
<br />t3 C_3 88t"1{-6,Fr"ltic-tr;tct/ t*9
<br />I hcrchy ofirnr unds rnalryorp.rjury rh
<br />i\\ucd (Scc.1097. Civ C ).
<br />ir{ con{ dbn kndin! rectry lor lh. pcrformncc ofthc work n,rshi.hrhis lrnrir is
<br />AITI.I(ITNLDECIJ&IiTIAIi
<br />I h.rc$y,Rnfl uMcr !$0llt ol Frjury onc ol lh.,nlhq ire {!(lararion\:
<br />Dcnlrirtun Pcnnirs A{b.sbs Nor ili.d ion F.dcralRctuhtions (TirL 40. Prn6)
<br />Rcquncd hlrcr or Mnifi calinl
<br />Essdinx ast csros rmvd arc not lppliclbLro rhn nmrccr
<br />n n sarc rhnr rhc rh,k inronndn n.onNr I.srerocomplywirhlllCiryandCounr,
<br />ing corM.rion. \rd h.r.by.urhorir rctEs.nrdrilcs ofrlis City and Couoryro.md uron rtr
<br />""**--7,6,,,9a m Et,-
<br />/?tq v
<br />PLUMBING-INSPECTOR RECORD
<br />-71
<br />a
<br />APPROVALS
<br />Gas-Underfloor
<br />e\
<br />Water Service
<br />{
<br />DATE J rD/SrG.
<br />i-i-
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